Association of Intravascular Ultrasound- and Optical Coherence Tomography-Assessed Coronary Plaque Morphology With Periprocedural Myocardial Injury in Patients With Stable Angina Pectoris

Kimura, Shigeki; Sugiyama, Tomoyo; Hishikari, Keiichi; Yamakami, Yosuke; Sagawa, Yuichiro; Kojima, Kensuke; Ohtani, Hirofumi; Hikita, Hiroyuki; Takahashi, Atsushi; Isobe, Mitsuaki

doi:10.1253/circj.cj-14-1375

Cited by 21 publications

(14 citation statements)

References 40 publications

(21 reference statements)

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“…Finally, PMN in our study was defined as previously reported. 13 The clinical relevance of post-PCI mild myocardial damage and the optimal threshold of hscTnT for PMN in CTO lesions remain unclear. However, previous studies have demonstrated a significant link between PMN and poor outcomes during follow-up.…”

Section: Study Limitationsmentioning

confidence: 99%

“…However, previous studies have demonstrated a significant link between PMN and poor outcomes during follow-up. 13 …”

Section: Study Limitationsmentioning

confidence: 99%

“…PMN was defined as a peak hs-cTnT value during the 24 h after PCI of >70 ng/L (5-fold the 99th percentile of the upper reference limit [URL]) in patients with normal baseline level [hs-cTnT <14 ng/L], or >5-fold the baseline level if pre-PCI hs-cTnT ≥14 ng/L). 12, 13 Additional laboratory data were obtained before PCI according to established procedures.…”

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confidence: 99%

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Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions

Kimura

Sugiyama

Hishikari

et al. 2018

Circ J

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imaging techniques. 8 Angioscopic atheromatous plaque components such as thrombus or yellow plaque have been pathologically validated 9 and previous studies have reported that CAS images might provide information on pathogenic substrates in CTO lesions. 10 CTO lesions have a considerable amount of atheromatous plaque, which may lead to distal embolization and periprocedural myocardial necrosis (PMN). PMN, diagnosed by elevated cardiac biomarker levels, is not uncommon and is related to adverse outcomes, even in patients with small elevations in cardiac biomarkers and clinically uneventful percutaneous coronary intervention (PCI). 11 However, few studies have reported the relationship between plaque components and PMN occurrence in coronary CTO lesions. We hypothesized that the combined use of IVUS and CAS imaging would give optimal evaluation of the tissue characteristics in coronary CTO lesions, clarifying the pathogenetic mechanism. Accordingly, we aimed to C oronary chronic total occlusion (CTO) is not uncommon in patients undergoing non-urgent coronary angiography. 1 Successful recanalization of coronary CTO lesions may improve long-term outcomes, 2,3 but understanding the lesion pathology is important for procedural improvement, leading to good outcomes for patients. A recent study demonstrated the pathological findings of CTO lesions in human coronary artery autopsies, 4 but the in vivo lesion morphologies and plaque components in CTO lesions remain unclear.Although intravascular ultrasound (IVUS) images are commonly used both for assessing lesion morphology and achieving good procedural results in CTO lesions, 5,6 the reliability of plaque characterization by IVUS remains undetermined. 7 In contrast, coronary angioscopy (CAS) provides direct visualization of atheromatous plaques, which may help assess coronary plaque components more accurately and with more detail compared with other

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Section: Study Limitationsmentioning

confidence: 99%

“…However, previous studies have demonstrated a significant link between PMN and poor outcomes during follow-up. 13 …”

Section: Study Limitationsmentioning

confidence: 99%

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Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions

Kimura

Sugiyama

Hishikari

et al. 2018

Circ J

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“…Previous studies have reported that OCT‐derived unstable plaques are associated with periprocedural cardiac biomarker increase . Tanaka et al .…”

Section: Discussionmentioning

confidence: 99%

Impact of coronary plaque morphology assessed by optical coherence tomography on cardiac troponin elevation in patients with non‐ST segment elevation acute coronary syndrome

Lee

Murai

Isobe

et al. 2017

Cathet Cardio Intervent

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“…The presence of OCT-derived TCFA is associated with the occurrence of no-reflow phenomenon, 46) post-PCI myocardial injury/infarction, [47][48][49] and microvascular obstruction on cardiac magnetic resonance imaging. 50) Greater amount of residual thrombus burden after aspiration thrombectomy is related to worse microvascular dysfunction and greater post-PCI myocardial injury.…”

Section: Oct Guidance For Pcimentioning

confidence: 99%

Optical Coherence Tomography for Study of <i>In Vivo</i> Pathobiology and for Optimization of Percutaneous Coronary Intervention

Sugiyama

Jang

2017

Angioscopy

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Intravascular optical coherence tomography (OCT) is an imaging modality uniquely characterized by its high resolution. OCT can visualize in vivo plaque characteristics and detect vulnerable plaque, such as thin-cap fibroatheroma, which has a large lipid pool with overlying thin fibrous cap. OCT can also help the clinicians to identify the underlying pathology of acute coronary syndrome: plaque rupture, plaque erosion, and calcified nodule. The OCT system enables automated measurement of the lumen diameter, lumen area, and lesion length, which is useful to determine appropriate reference sites, stent size and stent length during percutaneous coronary intervention (PCI). Evaluation of underlying plaque characteristics is helpful in predicting possible complications after PCI. OCT-guided PCI may acquire comparable angiographical and clinical outcomes to intravascular ultrasound-guided PCI. OCT can be used to evaluate characteristics of non-culprit plaque and efficacy of lipidlowering therapy on plaque stabilization. OCT also clearly visualizes mechanical vessel injury after stent implantation. Notably, the presence of irregular tissue protrusion has been shown to be associated with the occurrence of device-oriented clinical events. Recent studies suggest that OCT is feasible for the selection of conservative management without stenting in patients with acute coronary syndrome caused by plaque erosion.

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Association of Intravascular Ultrasound- and Optical Coherence Tomography-Assessed Coronary Plaque Morphology With Periprocedural Myocardial Injury in Patients With Stable Angina Pectoris

Cited by 21 publications

References 40 publications

Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions

Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions

Impact of coronary plaque morphology assessed by optical coherence tomography on cardiac troponin elevation in patients with non‐ST segment elevation acute coronary syndrome

Optical Coherence Tomography for Study of <i>In Vivo</i> Pathobiology and for Optimization of Percutaneous Coronary Intervention

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